After a brutal two years of the pandemic, it’s rare to hear good news about the health of women and girls — who have disproportionately suffered the socioeconomic impacts of Covid-19.

A landmark announcement in the fight against cervical cancer has given us something tangible to celebrate, especially for women and girls on the African continent.

The World Health Organisation Strategic Advisory Group of Experts on Immunisation (SAGE) announced on April 6 that a single dose of HPV vaccine — instead of the traditional two or three doses — delivers solid protection against HPV, the main cause of cervical cancer.

Why is this significant? In 2020, nearly 350,000 women died of cervical cancer, with about 90 percent of these deaths occurring in low- and middle-income countries.

The relative lack of cervical cancer screening and treatment in many lower-income countries makes prevention through immunisation even more crucial.

Despite this, currently less than a third of the world’s population of girls aged nine to 14 live in countries that provide the HPV vaccine; and within countries, populations who carry the highest risk but have the least access to health care may remain deprived of this vaccine.

Monopoly on supply

To women on the African continent, cervical cancer presents a significant public health threat. All but one of the top 20 countries worldwide with the highest burden of cervical cancer in 2018 were in Africa, where cervical cancer is a leading cancer killer of women — leaving an irreparable gap in the lives of their families, communities and societies.

But if only one jab is required to save lives, we have the opportunity to protect many more African women and girls against this deadly disease.

Vaccine equity has been a consistent issue since the first HPV vaccines became available in 2006. Supply constraints, along with high-income countries’ monopoly on supply, have meant that the global distribution of HPV vaccines is inequitable across geography, income and disease burden.

Less than 25 percent of low-income and less than 30 percent of lower middle-income countries have introduced the vaccine, compared with 85 percent of high-income countries. This SAGE decision is therefore a game-changer, meaning there will be more supply to go around.

At a time when African nations have had to spend precious domestic funds on Covid-19 pandemic response (not to mention grapple with the effects of the global economic slowdown), single-dose HPV vaccination means that every dollar invested in protecting girls against cervical cancer could go twice as far.

Through its market shaping efforts, Gavi, the Vaccine Alliance has managed to secure affordable prices for lower-income countries to access the HPV vaccine at $4.50 per dose, compared with US$ 100 in high-income countries.

To date, Gavi has supported 24 countries — including 16 African countries — to introduce the HPV vaccine, reaching more than seven million girls globally with this safe and effective vaccine. With yesterday’s SAGE recommendation, we can reach millions more.

School-based immunisation

So with all this good news, what stands in our way? Unfortunately, the Covid-19 pandemic, and related prolonged school closures, severely affected HPV vaccine delivery — even in countries that had already introduced this vaccine — putting even more girls at risk.

As the HPV vaccine is generally provided in schools to girls aged nine to 14, it is often the first time adolescent girls reconnect with the health system since childhood.

Sustaining school-based immunisation can also be a challenge, as most other vaccines are delivered through health centres. This means that systems and approaches must be adapted to the specific country context to reach these girls, and to empower them to protect themselves from cervical cancer — as well as to safeguard their health and well-being.

Given the disproportionate impacts of the pandemic on women and girls, we must seize this opportunity to prioritise their health and save their lives with the HPV vaccine.

We must move at speed to ensure that national, regional and global health strategies are updated; health care workers are informed of new protocols; health delivery systems are adapted; and vaccine manufacturers remain committed and flexible.

With only one HPV vaccine shot required, today we are one step closer to a world in which cervical cancer is eliminated as a public health problem.

A world in which, every year, hundreds of thousands of mothers, daughters, partners, sisters do not die from this preventable disease. A world in which every girl has equitable access to immunisation is a world in which we should all want to live.

Anuradha Gupta is deputy chief executive officer of Gavi, the vaccine alliance. E-mail: [email protected]